Testing the Waters

I just got finished reading this post by The Lonely EMT and she raises some good points, as is her custom. I was going to leave her a comment with some other things of the same ilk which I have learned or developed over the years, but I realized it would get kind of long (for a comment anyway) so I am going to break my 'fast' and have my first EMS/Fire related post in a very long time here.
 Linda writes at length about things we volleys do to maitain a level of 'combat readiness' in order to answer the call and we all have some sort of 'system' we each use. Some systems don't work all that well, but they keep getting used anyway. I know one EMT who will not run a call unless she brushes her teeth, but this same EMT never grabs her wallet (with her credentials) when she runs out in the middle of the night.
 I have my 'things' that I always do or never ever do, as applicable. I do many of the quick response tricks that Linda mentions such as considering what I am doing at the moment and what I will have to do if the tones drop. I often make "Go/No-Go" decisions in advance. If it is at a time when most would expect me to respond (holiday weekend when they know I'm in town) and I need to take myself out of service, I usually call someone and make sure they know I'm unavailable for the next hour and get them to cover the initial response minutes. We (my crews) are in the habit of casually sharing our personal schedules, so that others know if we are in town, having a family party, or otherwise unavailable. If any of us have had a drink, it takes us out of the game, so we let others know that in advance.
 Then I have my 'habits".
 During snowstorms or heavy rainstorms I bring my tunrouts in the house and have them ready to don, so that I don't have to do it in the Engine bay or on a roadside. During the winter months I keep all the temperature sensitive EMS stuff like NPA lube, Oral Glucose, and a few other odds & ends in a small zip lock bag inside my EMS coat which hangs by the door in the house. That way they are all ready to go, and warm. Ditto my steth.
 I have one of those rechargeable LED drop lights that hangs on the book case next to my bed. For late night calls I turn that on and it does not disturb the wife when the pager goes off and I flip it on. I carry that light through the house so I don't need any other lights on and it gets me out to my truck safely. It gets REALLY dark here too, just like at Linda's place. Oh and I ALWAYS have a flashlight in my pants pocket, 24/7/365, as well as in every coat pocket, especially in winter.
 My pants are always laid on the floor next to the bed, my shirt is underneath the pants, and my fresh socks are laid out flat across the tops of my boots. I could always find them in the dark and get them on correctly before I had that drop light. (Ironically I did not get this habit from the fire service, I learned it from all my back country hiking and camping. You need to locate all your gear and operate it in the dark in case he weather blows up in the middle of the night, especially in the winter.)
 I always have at least one bottle of water in the truck that I can sip from to clear my mouth and help hydrate on the way to a call, especially in the middle of the night. In the summer I keep a six-pack in the back seat, and in the dead of winter I keep a bottle by the light switch of the door I leave the house from.
 Some folks sleep with their socks on. I have trouble with this even when it's really cold in the house, but if I KNOW we are going out that night, I will do it on rare occasions. Yes, there are indeed nights when I KNOW we are going out, mostly due to weather.
 I keep on open type satchel in my truck that was given to me as a business promo. It was useless for business, but great for the Fire work. It has two outside pockets that are perfectly sized for my hi-band and low-band portable radios. the main pocket holds my EMS hip pack that has the basics (B/P cuff, stop-clot, steth, a couple of 4x4's, some band-aids, shears, Pulse-Ox, Glasses, pad, pen, etc), a pair of work (mechanics) gloves, small camera, ERG book, a stretch hat, and yet another flashlight. The other pockets have similar odds and ends like a multi-tip screw driver, some extra pens, and things of that sort. I call this my 'officers bag' and it's nice because when I respond, I climb in the truck and can turn on the radios without removing them. When I get to the station, I grab my turnout bag and this thing, which sits on the floor next to the seat. Everything I need is in there and it has worked perfectly for me for several years now.
 I also keep an old scanner in my truck that is always on. This scanner has our EMS, Fire and police 911 frequencies ( check your state, federal, and local regulations on this one). For me this is a HUGE safety tool. While on the way I can hear what dispatch is getting and giving all the involved agencies. This can either speed up my response, slow down my response, or completely change the manner in which I respond. I have two Fire Houses (out of 3 in my department) that I can get apparatus from. The details of the call will often dictate which way I turn, and what I get. We all know that the "Rollover with entrapment and fire" can very often be reduced to a 'property damage only' call after the first cop arrives on scene and gives an update. I like to know whats going on. I am not going to risk my life for an overheated car that somebody driving by called in as a car fire with entrapment because he/she saws steam and people sitting in the car. Knowledge is power. Conversely, if the dispatch was for 'chest pains' and I hear an update form PD that includes "CPR in progress' then yes, I am going to step it up. The scanner allows me to make intelligent decisions and act in a safer manner, based on the risk.
 Let me finish up by pointing out something that Linda alluded to, but I'll be more blunt. You have to think about your responses and analyze what you have done in the past in order to find ways to do things better, faster, and safer in the future. For instance, I almost never answer a call in the middle of the night without peeing before I leave (I'm getting old and the bladder does not work like it used to). I have also conditioned myself that on a late night call when I can't seem to clear my head and wake the hell up, I drive intentionally slower, much slower in fact. Being groggy makes me a hazard to myself and others. There is no sense in getting there quickly only to find yourself confused. So I slow down and give my brain time to wake up.
 Although this doesn't apply to most folks, it will for some. I respond for some special type calls outside my district where I work with other teams like Swiftwater rescue or Wildland Search. Obviously in the warmer months my swiftwater gear bag is in the truck, but not the winter months. Likewise, I seldom have my wildland gear in the truck because I own a room full of equipment and the gear is all specific to seasons and other requirements. So seasonally I have a couple of specialty bags or backpacks already loaded and sitting in my den near the back door. One bag is configured with the most likely general use, the other bag has the additional stuff I might need in that season. When I get to the staging area I pull from one pack to tailor what I need in the other pack. This could be maps, clothing, sleeping bag, ice axes, snowshoes, crampons, stoves, food, climbing aids, and a whole bunch of other things. The point here is, all this gear is in packs, ready to throw in the truck and in clean, working order. When I get a call for the rare search, I don't have to spend a lot of time finding gear or risk forgetting a key item (like a flashlight or GPS unit). I also have EMS kits configured for all occasions. For back-country wok I have a small carefully packed kit that includes a lot of stuff I would NEVER have or use on the street like over the counter meds, moleskin, a suture kit and such like. I have a small EMS back pack configured for what I might need to assist a wild land firefighter.
 Lastly, for the 'once every two years' long running incidents where I know I will be living at the firehouse for several days I have yet another gym type bag that I keep in my bedroom closet. It has my spare EMS pants, a second pair of boots, and it ready to have my toilet kit and the other odds and ends thrown into it. We generally have warning for these events like floods and hurricanes, so I just keep it handy and ready to fill while I am doing my other storm prep work. It acts as a trigger or reminder that I should get that stuff together in a bag as part of my preparation.
 Thinking about what could (or will) happen, and preparing for it is the name of the game. So do yourself a favor and think about it a little more than you already have. I bet you come up with some time savers that also make you a better and safer responder.
UU

Long Time Coming

Father forgive me, for I have sinned, it's been 2 months and a day since my last post....

Yeah, long time. I guess you all thought I was gone, and I guess I was. I was a-wandering out there looking for my soul, direction, and some other stuff. I buried myself in my music lessons trying to get away from the stuff we see. The PTSD had built up and I knew it was eating me up. I had nothing to write that was good or worthwhile. It was a dark place.
 No, I am not "back" and "healed". I am still working on that. Music therapy is helping (anybody wanna donate ticket money?) but I had my first really positive experience in a long time this week and I thought I might share it. It occurred to me that when we suffer a loss, a patient that does not survive, I mourn my shortcomings for anywhere between a day and a week, depending on the circumstances. But if we 'suffer' a win, I generally don't celebrate it for more than a day. That's not right.
 Several days ago we had a 'nasty'. 2 car MVA head-on, 110 MPH closing speed. As luck would have it, I wasa the 2nd EMS person in the car of the serious patient (the other driver RMA'd if you can believe). I took the head of a patient with a serious head injury, depressed skull fracture, snoring respirations, multiple lacerations, and very combative. Extrication was around 10 minutes (great crew), but we had difficulty getting her out because she was flailing. The flight medic was on scene in less than 10 minutes from dispatch of the original call because the were returning form a previous call. The first Trooper on scene was also a Paramedic and an RN. He got the main torso and assessment, while I took the head and did observations and support. Lots of blood in the car but no serious bleeds were evident when I got there.
 Once set up in the rig, we had 4 medics and 2 EMT's working the patient. It was like poetry even though none of us had much, if any time, working together before. We all held the same thought "This patient probably won't survive the flight to the trauma center".
 With all the critical calls I've done, this was my first 'squirter'. When the pressure in her head injury finally overcame the ability of the skin to hold it back, she blew a stream across the rig and shot a medic in the belly. I surprised myself because it didn't really mean much, I just moved my index finger over the hole and closed it off. We dressed it up when time allowed a few minutes later. It appeared she had a deviated trac and one medic placed his fingers to hold the trac in line while the other slid the tube in. Good hit on the first try. Good breath sounds, bilateral. The monitor showed good vitals considering and we all took 3 seconds to celebrate, as we kept working.
 This was also my first hot load. Normally the flight protocols call for shutting the bird down during the load operation, but in tis case the flight medic called the pilot while enroute and told him to 'wind it up and be ready to go" (this saves 2-4 minutes). So we loaded hot and had to maneuver the patient right past the tail rotor. Not a comfortable situation for me, having the handle end of the stretcher, but what the hell.
Off they went, and I collapsed on the tailboard of my rig, while the other guys started clean up. I was shot and began to sink into that depression that comes with the realization that even with all the effort and care, she probably won't make it.
 18 hours later there was a blurb on the local paper's web site about the accident and that she was in the trauma center in 'serious' condition". I was walking on air, she survived the night. "WOO HOO!" I thought. Then as the hours and days passed, pieces of information began to trickle back, either through medical channels, or the small town network, that she was conscious, knew her name, could wiggle her toes, etc. This gal is gonna make it, I thought. FINALLY, I get to work a bad one that doesn't turn out bad! This is, I kid you not, a first for me.
 Now I know, it's not about me, and the calls and jobs I am dealt, it is about the patient. However, I have gotten the feeling that if you are a patient in critical condition, you really don't want me showing up. It's my personal perception of a back cloud. I have never had a CPR save. I have been on some calls where I didn't expect the patient to survive and they made a full recovery, but this is the first time I have had a critical trauma patient survive. It's a very good feeling.
 About 0300 this morning we had an automatic alarm call that turned out to be false, but while on scene I ran into a friend of the family of this gal who gave me a update about the surgeries that had taken place in the past 12 hours. She said that the mother of this gal wanted to find out who had taken care of the girl's head during the incident, because the Doctors told her that this was probably what saved her life.
 I don't know what the physiology of the trauma is for this gal, but I have to tell you that as far as C-spine precautions go, this was probably the worst job I have ever done at stabilization. She was flailing and thrashing all over. I actually had my left arm across her upper chest, and had wrapped her hair in the fingers of my right hand the try and control the head. I felt like I was trying to restrain a prisoner. I was not happy with my methods. It was nothing that they ever taught me in class, and I don't recommend it. The mental picture of doing this had me awake that entire night, I felt like a failure at treating this patient in a controlled and proper way. Hindsight tells me that I got lucky. Next time I have to do better.
 At any rate, it's nice to have a winner. From what I can see now, it appears this gal will recover with most functions in tact.  I don;'t think she'll be the same as she was before the accident, but she will be alive and functional, and that's a lot more than any of us who were there could expect. I'll take that as a "win".
 With all the ugly and negative stuff I have posted here, I thought it was only fair to take an evening out and share this piece of positive news. Probably there is nobody out there reading this anymore, but on the chance that one or two of you have stuck around, I put this up for you.
UU

THE BEGINNING OF THE END PERHAPS

 I've had a lot of bad jobs over the years that make me reconsider what I am doing here in the Fire and EMS Service. As I tell the newbies 'Some folks are just not cut out for this stuff, there is no shame in admitting that when it becomes apparent to you.' Perhaps it's time to listen to myself.
 This last storm took more out of me than I think I had to give. The total devastation of property, livelihoods, and infrastructure in every direction around us was more than I could handle.
 In previous posts I showed some of the videos to give an idea of what was going on, but the truth is, they don't even begin to give you an idea. Two weeks on and many folks are still getting power back and re-connecting with the world. I don't care what the media, the politicians, or the utilities might tell you, the fact is a lot of folks have been left on their own because they are cut off from any real hope. Fortunately, those folks are like most self-reliant Americans and have done what needs to be done to care for themselves and their neighbors up to and including rebuilding roads on their own.
 Last night was the first real night of actual rest I've had in 2 weeks. No I have not been out playing hero every day and wearing myself out. I have been trying to balance home, work, and Fire Service responsibilities without a hell of a lot of luck. Every night I lay in bed conflicted by what I WANT to do (be out there helping), and what I have to do (go to work and be a good boy). I work in a small city that had no real impact from the storm, but I live in the hills. The folks at work have no idea how serious the conditions are just 30 miles west of town, and they really don't care. Last night I took my wife out (who is depressed and exhausted from all the family stuff she has been juggling) and we had a couple of beers, listened to some good bluegrass, and enjoyed the company of good friends and family. We returned home relaxed and I managed to get in 10 hours of sleep. I don't do that unless I am really sick or really drunk, neither of which applied here. I had finally relaxed for just a few hours.
 I came down to my desk and thought I could finally get a good blog post off, but every time I began, I just couldn't start thinking about this stuff. We are two weeks along and many of the critical repair project are pretty much where they were two weeks ago. The rain we had on Wednesday erased much if not all of the work that had been done. You might have heard about the flooding in PA and Binghamton, NY, but not a word was said about how it delivered a second blow in our area. Mentally, this was like being kicked in the head while already laying on the ground after a heavy beating for us.
 Take a look at this Associated Press video which was shot on Monday night of the hurricane 8/29 I think, just a few hours after the water started dropping. These guys were tired, but had no idea it had only just begun and would go on for many days after and they would start all over in ten days. Yes, all the evacuation sirens in this area were sounding off at 0600 on Wednesday 9/7/11 all over again and the evacuations began again as water flowed down Main St. in 4 different mountain villages.

I think I am done handing this stuff. I got into this, and stayed in it, to help people, my neighbors, but I have learned that we are constricted by our leadership. In my county this is a severe handicap. Although our leadership is not corrupt as far as I know, they are simply bureaucrats whose first order of business is to keep their jobs. They showed no courage or leadership in my eyes during this event. In fact, my personal opinion is that they willfully abdicated responsibility and virtually abandoned their posts. Of course, their press releases, when they did come out, made them sound like miracle workers. It was all bull. The people and the small towns they were supposed to help,  were on their own. The County leadership was, and remains, a house of cards. Witness this:

The reporter in this video rode her mountain bike up the road the day it was opened for foot traffic, three days after the storm came through.
 I was speaking with a Chief in a mutual aid department where I went out to help last weekend and he said "Yeah it was a bit hairy that night and I was gonna give you a call along with some of your other guys to see if you could come out to help with the Swiftwater work when it dawned on me that we were cut off and you couldn't get here anyway." He didn't really know how many rescues they did through the first rain period, just going from job to job like they were cellar pumps.
 I'm disgusted and burned out. I am re-evaluating what I am doing with my life. I don't think I can deal with the bullshit anymore. It took me all day just to get up the energy to write this post, and the only thing that is getting me through it is having some good bluegrass playing in the background to keep my conscious mind occupied.
 I've suspected for a while that I may have some of that PTSD stuff that they say builds up over time. I think this last event just pushed me over the edge. I have all the symptoms, short temper, mood swings, inability to concentrate, depression, the need to be alone, etc.. It's possible that I need a change of scenery. It's also possible that I'm done.
UU

I'm Tired

I'd like to say "WE are Tired" but I can only speak for myself. This past week had has plenty of work for everyone from linemen to EMT's. We've all been putting in more than any of us thought we could, especially the trained volunteers. The storm damage in my district was bad, but not terrible. I don't consider being without electric for 6 or 7 days a big deal. Tiresome yes, but just an inconvenience. The districts just up the line in our regular mutual aid areas saw almost total devastation. Main connecting roads through the mountains have been cut in half, isolating parts of the county. The statistics show it best, stating that this type of flooding should only occur once every 100 to 500 years. It was the worst natural disaster to hit our County in recorded history.
 So why am I tired? Well, it's not so much the 'why', but the 'what' that is wearing me out.
I am tired of politicians getting in front of every camera available to tell the voting public how hard they are working, when they can't supply us with the materials or resources to do what needs to be done.

 I am tired of these same politicians that can't use their 'on air' time to get critical information to the general public about what is going on, how they can help, and what is needed.

 I am tired of hearing people come into shelters telling us how rough they have it because they don't have hot water, electric, or cable TV. The sit at the shelter and whine when they could be helping a neighbor who has REAL problems clean out the mud from their home.

 I am tired of news crews sticking cameras in my face looking for a story while I am just trying to do my job.

I am tired of getting 7 good clean hours of sleep, only to wake up exhausted from my dreams.

I am tired of driving my engine over roads that may give out from under it at any time.

I am tired of the tourists that don't understand simple signs that say "LOCAL TRAFFIC ONLY" or "ROAD CLOSED".

I am tired of tourists that feel it is more important for them to get good pictures of ruined homes and livelihoods than it is to get the hell out of our way and let us do our job.

 I am tired of seeing my brothers and sisters in the service working 20 hour days and not having been home to take care of their families and damaged homes in over a week.

 I am also tired of seeing other 'brothers and sisters' who could easily give up some of their spare time to put in a 12 hour shift to let some others check their families and get some sleep, but instead turn a blind eye to the need.

 I am tired of road crews that drive around downed trees and lines because "this is not 'our road'".  Take 5 damned minutes and top the tree and open the road making it safer for EVERYONE.

 I am tired of walking around with a lump in my throat from seeing all the ruined lives and homes.

 I should also mention what lifts me up and gives me hope.
 I am encouraged by relief workers that know their job, work tirelessly and always manage a comforting smile and supporting words for those truly affected. (You can usually recognize these folks by the bags under their eyes and the tired expressions when they think nobody is looking.)

 I am Encouraged by the citizen volunteers that step and and offer to do any task and don't walk away when they realize it is hard work. They stay there, get the job done and move on to the next task. (You can recognize these people by the sweat stained shirts and the constant upbeat attitude and smile on their faces.)

 I am encouraged by the Civil Engineers and equipment operators who are faced with incredible challenges and are stepping up and making it happen, pulling off engineering marvels of reconstruction I would have never thought possible.

 I am encouraged by Volunteer Fire Chiefs and Officers that have stepped up and worked non-stop  for 8 days to do whatever could be done to organize communities and help their neighbors. Never turning a person in need away, and never losing patience, in spite of all the "help" they were getting from the politicians.

 I am thankful to Be'la Fleck and the Flecktones who could have understandably canceled their concert in the heart of the devastation and instead worked to make sure they could put on the show and turned it into a benefit for the victims. On top of that, they invited all the first responders and their families in for free. What a great night and welcome respite from the carnage. Be'la and the band came down on the floor after the performance and spent time sharing stories of their own losses in the Nashville earlier in the year, as well as listening to the stories of those affected here and now. They truly are a fine bunch of gentlemen and spoke with us like old friends.

 Here is a slideshow of the area showing some of the damage. The stuff further up the mountains doesn't appear here because those areas are still being opened up.

I spent a 12 hour shift out in the heart of these areas yesterday so that some of their crews could attend to their own families. This is the third '100 year flood event' those folks have seen in the last 5 years. Most came back to work as soon as they could, some never left the station. It was strange to pull in and report for duty when the first question they asked us was "what can we get for ya'? Did you eat yet?" Their hospitality was ingrained, I guess. We came out to help them and they were making sure we were comfortable and well fed. Just amazing.  Anyone who came into the station could not leave without being asked "Is there anything else we can do to help you?" Yeah. we worked hard doing cleanup from the previous days 'relief drops and public distributions", but they treated us like family. We helped distribute RED Cross supplies, give directions to Federal Workers, find sources for odd requests, and generally make ourselves useful. We put their station back into normal response mode before we left for the night. We came home very tired last night but feeling good about a hard day of meaningful work. I should have known it wasn't over, we were driving back to our station around 2100 and were flagged down by a LEO who inquired if we could assist with a cardiac emergency. We did the initial workup and treatment for a lineman in his truck that could barely remember what day and time he had come into work. An odd call in another district that brought together responders from 4 agencies, including an off duty State Trooper/RN/Paramedic who happened to be getting gas for his generator. One final example of people working together without boundaries.
 It's been a long eight days, but I've had it easy and God was good to me and mine. Many of the people I've talked to and worked with over this week will takes years to recover, some never will.
UU

Grey Fox, In a Nutshell

 Well, first I have to apologize for not posting from the festival as I had hoped. The wireless connection did not work for the first day or so and by the time it got fixed, I was into full festival mode and didn't have much time available. I took only a few quick pictures, but this might give you and idea of the site size.

 What you see here is a shot from the main amphitheater looking out over the camping area. That large tent on the right is a shade tent so you can watch the main stage (off to the left) while staying out of the sun. The large tent in the middle is a food concession tent, and beyond is the camping area.
 Here's a shot of the main stage taken in the early morning before anybody is up and about:

Off on the left side you will see a large tent where they feed the staff and the entertainers. The Green Room is also over there on he left.
 First let me start out by saying that on this particular weekend I collected several memories that will last me into the nursing home phase of my life, and I don't say that flippantly, I had a sore jaw from smiling so hard for so long.
 As it goes with these things, it started off slow. At the initial briefing I could see we had an ample staff, many returning from last year and some new faces. Many were from the clinical side of the health care business and I knew that the tent would be well staffed, but I also knew we wouldn't have a lot who would easily go out roaming and looking for problems or patients, which is what I prefer to do. Clinical folks like to stay in the Clinic, EMS folks like to be out on post. My partner from last year was doing an overnight and we wouldn't be working together much this year, so I found a FNG and we walked around as I gave him a tour, explained what to look for (folks doing dumb stuff) and some of the tricks (you can sit in the VIP section while you are walking around) and how to scout for the good parties to return to after the duty period. He learned fast and when my daughter arrived I left him to his own desires. I was looking forward to spending some time with my little girl who was also volunteering this year with the drink stand crew. Since she's been married we haven't had much time together. Little did I know we would wind up just having a blast together.
 Medically speaking we saw just what I had predicted in a prior post. Each night we had one or two hopelessly drunk folks that required some attention because they were puking too much, dehydrated, or unable to ambulate. In one case we arranged a transport for an old gent that was incontinent after ingesting a lot of alcohol and THEN deciding to try some pot after 20 years of abstention.  He did some puking too. OK, a lot of puking, and all that stuff combined with his meds to wreak havoc with his system.
 My turn on the overnight looked to be quiet even though it was Saturday night (the last night to party) We had buttoned up the Medical tent and I was just settled into my chiar to doze when a guy came in all frantic stating that "We CAN'T wake her up, we don't know what's wrong, it looks REALLY BAD!" I poked my head out back and told the boss we had a worker. He came out an asked a few quick questions while I and my partner collected the bags and loaded the golf cart (the preferred mode of transport in dense population areas). The 4 of us got off in the cart and were moving as fast as we could follow directions, part the crowd, and see where we were going. I was riding backwards and was trying to don my gloves as we flew over the hillocks in the hayfield that was now home to about 6,000 people. We arrived and found our patient in a tent which was filled with a full sized air mattress. This was a new sensation for me, like working on a waterbed. The Boss went in first with my partner and realized all at once that a) this patient was critical, b) this patient was a friend of his, and c) we needed ALS right away. He crawled out and gave me the nod as we switched places, he went into ICS mode, calling security to get a rig on the road and giving a quick Sit Rep. My partner and I worked on the basics: Breathing adequate but shallow, pulse 126, b/p of 135/88, posturing, possibly post-dictal, jaw clenched HARD, blood residue on the cheek, possibly bit her tongue, and she had paticial hemorrhaging, which we took to indicate a possible brain bleed. All in all, things didn't look good. We could not get a med list from her drunken husband, but we knew that there was a list somewhere. What made us really concerned was that we were repeatedly assured that she had no been consuming and alcohol or drugs. She was very health conscious and did not drink. It took 2 of us to do a B/P, one to hold the arm straight and the other to take it. Her arms would fold right up when we let them go. ALS arrived, we extracted her on a long board and we loaded quickly.
 Turns out she had hyponatremia (look it up, you should KNOW this) and was in a coma. In her efforts to avoid dehydration, she had hydrated herself right into a seizure and coma. First time I have ever seen that. 48 hours on I got word that she had come out of the coma and was expected to make a full recovery with no neurological deficits.
 After I went 'off duty' at 0700 we were headed back down the hill form breakfast when a call came over the radio for a male, unconscious, at the main gate. We were already mobile, so we took the call. He had had a seizure and was incontinent to bladder and bowel. He was embarrassed and denied any LOC, but the witnesses said that he was out for a full minute. He had a lump on his head where he hit the side mirror on his car (and broke it clean off) but wanted to RMA (AMA). It took us a half hour to convince him to go in, but we finally succeeded,
 All in all a fantastic weekend with wonderful music and people. I got to have dinner one night with a Bluegrass legend (look for a future post on this, funny story) and build on our friendship. I had some priceless time hanging out with my little girl and my son-in-law, and I witnessed some events that I will remember for a long time. As a bonus (as if I needed one), my Bluegrass legend friend has offered to take me on as a personal challenge to teach me how to play the 5 string. He offered me 4 or 5 hours of his time and promises he will have me playing the darned thing before he is done with me. Now I LOVE this man and have listened to his music since I was a kid. There are thousands of people around the world who would give anything to have just one hour with this guy. I fully understand what has been offered me. But on the other hand I realize that after 32 years of varying attempts, I couldn't carry a tune with a wheelbarrow. I told him as much, but he seemed resolved. I also told him that if I were the one to break him and he failed, I would feel terrible. He seems unconcerned and has high hopes. I warned him. My daughter tells me that my son-in-law kind of set this whole thing up because he wants me to play with him. She says I'd be a fool to let it go by. Smart girl. OK, I'll play along. Even if I come out as the same idiot as I went in, I will still have spent a few more hours with someone who changed the course of Bluegrass music and I both admire and am amazed by.
 Here's a shot of Bill giving a workshop on Friday. He does one on Saturday also and a stint on the Master's Stage as well. Bill is around 73 and it still amazes me to see him light up when he sits down and begins to share what he has learned. 

 I returned home from the festival, took a shower and got a 4 hour nap (having only an hour of sleep in the past 36 hours. I was on duty with my Squad on Sunday night and hoped for a light night. The EMS Gods were against me. I went to bed at 2300 for the night and the pager went off at 0000. We had a fire on the mountain that kept us out until 0530. Normally fires are easy duty for EMS, but I was assigned as the EMT to stay with the crew on the fire. We had 800 feet of near vertical climb to get to the seat of the fire. It was so steep that we went up on hands and knees, clawing all the way. You could not stand, nor could you sit. you would either slide or fall down. Three quarters of the way up. when I got to a point that I could keep an ear on the crew, I dug in. Somebody needed to hold onto the hose to keep it from sliding back down the mountain. I dug out a seat belay and settled in for about three hours and helping relief folks climb up the hose line, watching fire progression (below us, above us, and to the west of us).
 When we finished up, I had enough time to grab a shower before heading into the paying job, where by the way, I was a little useless during the day. Somehow I figured out that I had gone 60 something hours with only 5 hours sleep.
 So now you have an idea of why I haven't posted in a week. Aren't you sorry you asked? I should have been working on my pick rolls tonight, but instead I thought I should get this one up for you. Also, for Linda, I got your message and I understand how life changes direction. We'll get it together, just a little further down the road. Right now I just need some recovery time. Oh BOY do I need to recover.
Be Safe, B Sharp,
UU

Grey Fox, the 4 day duty crew

 So let me give you a little background on this Bluegrass Festival and why I am back for another year. I am not very good at counting heads, but I believe the gate for this event is about 10,000 people, for 4 days. Most folks come and camp right here at the site, which was, just two weeks ago, a working hay field. The last cutting was done just last week, before they cut the roads and laid out the site. There are a LOT of people and campsites. They come in all manner of vehicles, from cars to campers, to buses, and they set up some weird stuff in the interest of having a good time. Some have been making this trip for 20 years. There are lots of kids running around, it's family time for many. It's drinking and picking time for others. You can find some photos here to give you the flavor.
 The Festival (music) starts on Thursday, but the gate opens on Wednesday morning at 0700 sharp. There is a line to get in. I would love to go up early, but can't get the vacation time. EMS Staff are required to report by Wednesday evening (we have a briefing at 1900) and the shift assignments are roughed out. Each volunteer is required to give 4 hours a day to earn their keep, but many of us work more because it's easy work and we are having a good time. In my case, I mostly do a walking patrol with a partner to keep an eye on the folks in the camping areas, the 4 other stages, or the Main Stage. With an assignment like that what difference does it make if I am on duty or off, that's what I would do anyway, walk around. Plus, while I am on duty, nothing is off limits except the Green Room. Backstage, VIP seating, and every place else is open to us.
 What we receive in return for our highly skilled and professional services (I know you're wondering) is a full pass for the weekend which includes camping and normal access when we are not working, as well as 3 square (and incredibly good) meals each day we are there. I have never been treated better as a Volunteer than I have at Grey Fox......never.
 So how busy can we expect to be? Not much, considering the demographics. We call ourselves "The Stinky Foot Patrol" because mostly what we get are foot injuries from folks who are not used to walking on a freshly cut hayfield. We get folks who have the wrong shoes, or old shoes, or no shoes. We get folks who arrived with an open foot wound and now it's become really ugly because they are walking around in sandals. We get a LOT of 'foot stuff'. Fortunately, we have on our staff a number of kind and caring RN's who easily and compassionately clean, dry, treat, and dress all these wounds. They offer advice to get the patients through the rest of the weekend. We give a lot of advice to people on how to enjoy the weekend and take care of their own medical issues at the same time. We also get the occasional 'true emergency' like anaphalaxis, diabetic issues, and the rare chest pains. Mostly, it's feet, dehydration, and sunburn. But the people are very nice and appreciate the help, so it's all good. The work is fun if nothing else. We average about 7 people transported during the 4 days. Al transports are handled by local EMS, which we work well with.
 Our staff is composed of EMT's, Ski Patrollers (OEC), a couple of CFR's, several RN's, a PA or two, a few Paramedics, and other odd medical disciplines. Of course, many of the folks carry multiple credentials like Wilderness First Aid, Wilderness EMT, OR Nurses, and we even have an EMT who is a Dentist. It's a neat crew. The RN's like doing the wound care but back off when an emergent case comes in because they don't have the tools, facilities, and drugs they are used to having. On the other hand, the EMT's shy away from the wound care and foot washing, preferring to work on 'something with a little more meat'. Infection control is not something EMT's deal with very often. So we have a very nice symbiotic staff that works well. In addition, we come from all over the northeast, so we don't see each other more than once a year. We enjoy getting to know each other and share tricks and techniques.
 So that's a little about how things layout her. Now lets see what the weekend brings.
UU

I'm Thinking

Yeah, I know, it's scarey.

 So when I read TOTWTYTR latest post tonight titled "A Real EMS Post!" I thought 'Hey Great, I miss those because they're always good'. Then I relaized that I haven't written one myself in quite a while.
 I should do something about that, I thought.
 But nothing much has happened and there are few (OK, NONE) burning issues on my mind. In short, nobody has pissed me off lately. Pity.
 But then I remembered "Hey, I am about to take off on my favorite EMS duty cycle of the year, why not write about that?"
 So tomorrow, when I leave the paying job and head up into the hills, I will try to keep YOU, both of my readers in mind. I'll bring the laptop and see if I can't manage a post or two from the biggest Bluegrass festival in the great Northeast.
 Of course, if you are coming to Grey Fox (you probably are on the road as I write this) please do drop by the medical tent and ask for the handsome EMT with the long mustache. Most likely I will be walking foot patrol because that's what I like best, but I will have at least one of the overnights. So look for me.
 I have no idea how it will come out, but it will give some sort of Festival EMS perspective that might be interesting.

 Let's see what develops.
UU

The rest of the Story

 Well, you've waited long enough, here are the details missing from the previous post. But first, I neglected to mention that this patient had nothing between him and the Lord except a pair of boxer shorts. No Shoes, no shirt, (no service) nothing.
 Turns out our hapless patient made a phone call at about 0300 from the residence where he was staying. At 0330 he was found in the living room of a house about 2 houses down. The homeowner asked the patinet to 'please leave', which he did. At 0350 he returned to the same house, whereupon the owner threatened to have him arrested. Fearing the threat, the patient took off in haste, apparently into the woods and stumbled around for a while and somehow lacerated his leg.
 Bleeding profusely, he looked for another place to get help and found a house which was unoccupied. He broke in and soaked several handfuls of paper towels with blood trying to stop the bleeding. He tried laying down (on the Judges bed) to see if that would help. Apparently, it did not, as he left several very large puddles of blood on the bed which soaked into the mattress and had still not congealed several hours later.
 He then left the house and began walking up hill, down the middle of the driving lane in the opposite direction he had started from. After a half mile, the blood trail wanders around for quite a bit, then heads back down the road, this time mostly along the double yellow line until he passes the house he broke into (the second one) by a few hundred feet. At this point he is running out of juice and he sits on the side of the road in the cool tall grass. Someone driving to work sees him at 0500. He was found by a woman out taking her two small grandchildren for a morning walk at 0800.
 Two counts of Criminal Trespass and one count of Burglary has him being held for bail in the County Lockup.
 Now the thing that surprises me is that if you find somebody in your house, without your permission in the wee hours TWICE in the same night would you not call the police?! I believe I would have (right after my hearing came back from the shot I fired). I would also like to think that if I saw a mostly naked person sitting in the grass at 0500, I would most likely call a cop for assistance. But that's just me. Some folks might see it differently.
 You just can't make this stuff up.
UU

Did you ever .... ?

Did you ever have one of those calls where you found yourself saying "I can't wait to hear the rest of this story!"
 Sure you have, and we had one today. No I don't know the rest of the deal yet, but I'll share it when I find out, you will have to wait, just like me.

  We were banged out for a 'adult' male, severe laceration to the leg. According to my GPS, I was 30 minutes from the scene because I was returning from dropping my wife at the airport and I knew there was no way I would be of any help unless it turned into something more. So all I could do was follow the city fellar down the two lane at 45 MPH and listen to the chatter on the radio.
 Follow-up information during response included that it was a 40 Y/O Male with a severe laceration to the right lower leg. He was found on the side of the road by a passer-by. HMMM, I'm thinking, "Must be a cyclist, we have lots of those on the holiday weekends, we live in a paradise for bikers." Then I heard the LEO on scene ask his back-up unit to continue in and that the scene was secure for EMS to come on in, he also confirmed the previous medical information and added that the bleeding was controlled. "What? 'Scene secure'? They didn't mention the scene was NOT secure with the dispatch or to stage away at any point. What the hell is going on?"
 So I arrive on-scene after the ambulance has carted the patient off to the hospital and my guys are just getting ready to leave.  The young Lt. brings me up to date "Wow, major lac 12 inches long and down to the bone, bleeding pretty good. No, he wasn't on a bike or any vehicle of any kind. He had four different stories that all ended with 'but I don't really remember', and the police are following his blood trail up the road now." I smiled and had 'that thought' I mentioned at the top of the post.
 Turns out we wound up having about 5 or 6 LEOs doing the 'investigation thing' and we lent them a hand by closing the road to preserve evidence and the scene, which turned out be to nearly a half mile of blood trail that included the inside of one home the patient had apparently broken into and bled all over the place. Apparently the homeoners were away for the holiday, at least I hope they were.
 It gets better: the home our patient choose to do his B&E on was a prominent local figure of the Judicial persuasion. He's gonna be ticked when he returns, and this patient may very well wind up in his Court.
 The patient was found not knowing where he was or how he got there. He said he was from Baton Rouge, which is around 1,000 miles from here. He was staying at a house down the road and remembers A) Going out for a walk, or B) Going to buy a bottle of wine (5 mile round trip), or C) Being dropped off. He either was, or was NOT in a vehicle at any time. He either was, or was NOT partying with friends. He either was out for a couple of hours, or all night. But whatever it was, he doesn't remember.
 I'm not real good at assessing blood loss when the trail is a half mile long, but I figure that this guy lost a fair amount since we had little trouble following it on a road that was still wet from the previous night's rain. We also had little trouble finding where it started (in the middle of the driving lane), without the aid of a dog or a CSI team.
 I can't WAIT to hear the rest of this story!
 And the Holiday weekend isn't even over yet! We still haven't done our 'Drunk stumbles into the campfire' call, or the 'Deck fire secondary to a barbeque experiment' job.  Last night it continued to rain as it had all day, so today should be the big day for us. More blog fodder, if nothing else.
Be Safe, Be Sharp, and Please Don't be Stupid,
UU

Really?!

 Direct from the "You can't make this stuff up" department, I just heard this dispatch a few minutes ago for the next county north of us:

"Podunk Rescue, respond for a 21 year old female with a Q-tip stuck in her right ear. 2123 Birch Lane, in the village of Smallville. Airway is patent, breathing and pulse normal, no chest pains.  Repeating: Podunk Rescue, your response is needed at 2123 Birch Lane in Smallville for a 21 year old female with a Q-tip lodged in her right ear. Suggested ALPHA response, dispatcher 23, 1709."

Several things went through my warped mind all at once. First of all, if I were the typical 21 year old female, would I call an ambulance because I was dumb enough to get a Q-tip stuck in my ear?
 The second thing that struck me was that the dispatcher was placing emphasis on the fact that the foreign object was lodged in the RIGHT ear. I wonder if he was concerned that the crew might arrive and not notice that the cue-tip was in the RIGHT ear, or perhaps they would arrive and say, 'nope this gal has a Q-tip in her left ear, must be the wrong patient', or as a third possibility they might not catch the Q-tip in the ear at all during their assessment.
 A few minutes later I thought "HEY, what if it's not a Q-tip, but rather it's a CUE-TIP (like in pool Cue)? Now that might be hard to miss on an assessment. 
 This county uses a coded response mode with Alpha being the least critical and Echo being the most critical.

No matter how hard you might try, you just can't make this stuff up.
Be Safe, Be Sharp,
UU

Keeping Score

 The Instructor stood in front of his class at the conclusion of the first successful CPR training for each of these new students. As he got them quieted down he surveyed these new faces going out into the world as newly ordained 'lay rescuers'. Most were between 20 and 30 years old, but some were forty and one was in her sixties. All were civilians.
 "Newbies", he thought, but then he chastised himself for thinking that. "These are just folks trying to be prepared to help somebody else out when they need it most". His thoughts were his own and he congratulated himself on getting a new batch of people out there. This is why he teaches, after all, to possibly save a life through the actions of others.
 "OK Folks" he spoke up "lets quiet down. Before I let you help me carry all this 'stuff' out to my truck I want to congratulate you on doing a fine job. Everybody passed and did it well. You are all in good shape. Just remember if you are ever faced with any of the situations we discussed today, just stay calm and follow your training. I KNOW you are going to do great. Are there any final questions?"
 A hand shot up from the cute 20 something with the long brown hair. "You told us that you have done CPR many times, how many people have you saved?" "Well," he looked at the floor then looked back up, "I've been...er, check that, I have had a few patients that have been lucky and come through it OK as far as I know."
 "Hey, wait a minute", it was the smart ass kid in the corner that was cracking jokes all through the class. The Instructor had just about had enough of this kid. "Your job is saving lives, are you telling us that you don't KNOW how many people you've saved? You don't keep track of something like that? You're weird dude!"
 "Yeah" the Instructor said, "I guess I am a little weird. The truth is, I have no idea how many saves I've had a hand in. First of all we don't get good feedback after we bring them to the hospital , and many times I have no idea how it ended for a lot of patients. You probably won't understand this, but we do the best we can for every patient and hope for the best. I only keep track of the others."
 The kid in the corner didn't get it yet, "what others?"
 "Ah Shit" he thought, "I said that out loud didn't I?"
 The instructor looked the kid in the eye, waited for a second, then said in a firm voice "The others that didn't make it, I know that number, it's 37. He went on, "I didn't want to tell you that because you might get discouraged, but every person that is trained and 'out there' will increase the chances that CPR will be started sooner and increase that patients chances. You can make a difference. That's the point. Don't focus on what might go wrong, work toward what might go right." He looked around the class and studied the faces.
 "Damn" he thought "I went and scared them. Time for damage control."
 "Look, I know this all sounds pretty heavy, and in a way it is, but you have to realize that all you can do is what you can do. If you TRY to help, and do the right thing, then you are not responsible for what happens if it doesn't go the way you want. You did more than many people could or even would have done. You should be proud of that. It takes a damned lot of courage to walk in this room like you did 6 hours ago, and take this class, then walk out prepared to do something that will seem a little unnatural at first. My work doesn't allow me to 'pick' who I want to try to save and who I don't. When I get the call I go, and do everything I can within my training and leave the decisions to a higher power. After a while, you learn that you can't think about it too much because the outcome is not really in your hands anyway. Your 'job' is to do 10 minutes of good quality CPR and I know you can do that."
 He did another 'face survey' and could see the wheels turning in almost every head. "If anyone wants to hang out a little after we clean up, I'll be happy to stay and finish that pot of coffee with you. Just understand this, you are not expected to be 'heroes', but you might be looked at that way if you ever need to do this because you might be the only one who knows what to do. Doing the right thing is not always easy, but it is why you are here, and why I am here. I thank you for showing me the courage you have, and I wish you all the best of luck. Anyone want to help me load the truck?"
 The smart ass kid in the corner jumped up and grabbed two big bags of CPR dummies.

Be Safe,
UU

Rough Week

Yeah, it wasn't really good for us around here the second half of this week and as a result I will be attending a wake and a funeral over the holiday weekend. (See previous post and associated comments.)
 Last night we had a CISM session. Now let me say that after all the ugly jobs I've been involved with I have learned a few things about stress, grief, emotions, and all the stuff that comes along with the heart wrenching jobs. I am certainly no expert, and you should absolutely not take what I say as a guide. However I have learned that we each have our own best coping mechanisms. My suggestion is that you find what works for you and use that whenever you feel the need. My personal experience supports most of the psychologists research, to whit: Drinking alcohol to excess doesn't help anything, exercise does. Talking to a trusted peer helps a lot, getting it out is important, and you need to do it with a protected source so that you feel totally comfortable.
 CISM (Critical Incident Stress Management) works for some, but I can tell you that it doesn't work for me. I am too inhibited to cry and talk in front of those who I must also lead. Every time we do one of these, I walk out feeling exposed and that doesn't help me much. None the less, it might work for others, so I support the process because the important thing is that my people get whatever they need to get them through whatever they are going through, and that they can get 'it' in whatever format works for them. So we use a combination of CISM, peer support, and various ad-hoc methods (drinking beer around a campfire, coffee at the deli before work, bullshitting after drills or work parties, whatever). We call and check in with each other to see how we are doing.
 So I survived the CISM session last night as did everyone else. It was the first time for a lot of those involved in the job, actually I think there were only 3 of us in the group who have been through this before. The rest were all newbies to the process. The session took more from me than I got out of it, but I hope some of the youngsters found it helpful, especially my son. He witnessed, on this call, the first of his peers to die as he watched. He lost someone who was his closet friend all through grammar school, middle school, and a good solid friend through High School and into adulthood. Three days on, and I don't think it's really hit home for him yet.
 As for me, I started my personal flavor of CISM this afternoon by leaving work early and doing this...

It's a 3 minute drive from my house, and a mile and a half hike in from the road. No people, no noise, (no fish), and nothing to do but think and sort things out.
 It works for me. In fact, It worked so well, I might do it again this weekend.
 I'll miss you Woodchuck, it was an honor to know you and watch you grow into a man.
Be Safe, Be Strong, Be Sharp,
UU

When Firefighters Cry

When Firefighters cry, it is without shame.
When Firefighters cry, it is not because they could not do more, but because there was no more that could be done.
When Firefighters cry, it is a visceral and painful cry that creates an actual muscular pain within. It comes from deep within their soul.
 When Firefighters cry, it is not because they didn't do their best, it is because their best wasn't good enough...tonight.
 When Firefighters cry it is because they understand, better than most, how unfair life, or death, can be.



There are days, not many, when I hate this job. Today is one of those days.
UU

It's been a while...

Any of the folks who drive in my agency will tell you that when I am in the back I will tell my driver "Nice and easy to St. Nearest, if you please" and that I will say that 99.8% of the time. I don't like hot runs to the hospital for safety reasons and only would consider them if the patient was probably not going to make it unless we gained every second we could or there was nothing more we could do for this patient outside the Hospital.
 So I can tell you that I can count the number of hot runs I've had in the last 5 years on the fingers of one hand. The other week we had one and we all got to test out our sea legs. I can also tell you that I am now very familiar with the appearance, texture, and odor of  'coffee ground emesis' as well as 'coffee ground feces'. I could have gotten by without knowing what each looked like when spread, in copious quantities all over the floor of the ambulance. I got a case of the dry heaves on this one, but I kept working. The rig needed a good hosing out and decon anyway, and what better time than 2am on a Monday morning?
 I hope he made it.
UU

Long Enough

"How long have you been doing this?"
 Every time he gets asked that question, he either looks at the ground, or off in the distance and just says quietly "Long Enough."
 Usually the questioner senses the immediate change in his demeanor and changes the subject, sensing that they either hit on something he wishes not to discuss, or perhaps they are afraid of the answer they might get to the next question.
 Truth be told, he is actually expecting that next question, but it never gets asked, at least not yet. On the day he does get the second question, he'll answer that he's been at it long enough to loose that swagger that you are issued with your first EMT or Firefighter Certification. He's been doing it long enough to know that all you can do, is the best that you can do. He's been doing this long enough to know that you can see something new at any given moment and you have to handle it. He's been doing this long enough to know that he will never see it all. He has been doing this long enough to laugh at those who claim they have 'seen it all', because he knows them for the fools that they are.
 He's been in this long enough to know that the pain of somebody else's tragedy can take a long time to ease. He's been doing this long enough to know that life is nothing like a TV show. He's been in this long enough to know that some die even when you think they'll make it, and some live even though there is no hope for them. He has been doing this long enough to be humbled by the complexity and resilience of the human body, as well as how frail it can become at times.
 He's been doing this long enough to know that making judgements about people and their life situations is both wrong and a waste of time because mostly, you can never really know what their situation is, or how they got there, and any judgements you make will likely be terribly incorrect.
 He's been doing this long enough to learn that laughter, especially in the back of the ambulance, is a precious thing and can have great healing powers.
 He's been doing this long enough to know that he is just a cog in the system and that his purpose is more to provide comfort than treatment, but both are important.
 He's been in this long enough to believe that the greatest invention of the 20th century was home smoke detectors and he can't understand why everyone doesn't keep them installed and working.
 He's been doing this long enough to have made friends with many of the ghosts that haunt his nights, but he is still working on some of the others.
 He's been doing this long enough.
UU

Hang in there

 Sorry folks, I know this sounds like another excuse, but life got in the way. The better half (otherwise known as my wife) insisted that I could not dedicate my Friday night Saturday, and all day Sunday to my Fire Department activities. The selfish person that she is, required that I take at least 4 hours out of my weekend to preform some family obligations (can you imagine?!).
 This weekend, it meant car shopping. We NEED to replace my (9 MPG) truck. So off we went to "shop". Never, in my wildest dreams, did I expect to actually buy something. But buy something, we did. SO I spent yesterday afternoon, until O-DARK- THIRTY taking all my stuff out of the old 2500. Radios, Lights, gear, and ten years of 'stuff packed in every corner ' in case I 'might need it on some call'. The radios and antennas were the worst part. I did a really good job installing all that stuff and snaking wires every which way.
 I got it done and today we made the trade. So now I need to figure out how to get 'most' of the stuff from my 2500 into a little Dakota Quad Cab. My response gear more than fills the back seat (I think a bed cap is in my future) and after 2 hours of looking it over, I have no idea how, or where to run all the wires for my radios and lights. This is gonna take a while. I stabbed a dash light against the windshield and that will have to do for now along with a scanner to listen to what is going on. I managed to get the basics in the back seat: swiftwater rescue bag, wildland gear bag, Structural gear bag, EMS jump bag, wildland SAR pack, and the O2 bag and AED.
 At any rate, I'll be on this for a while, not in a rush, but it's another time burner. I took a half vacation day (my first) just to stand here and look over my new ride. The only thing I really did, besides load my gear in, was to stick my Officers plate on the front so that folks will recognize me and wave. It will take about a year before all the other Firefighters and Cops get used to what I am now driving. I had the old truck for 10 years.
 So I'm still working on the Blog Post ideas I had and it is coming together in my head. I just need time to put it down. I'll be running a session for the Little League Coaches tonight, and my LAST OSHA class (cue the big two handed air-pump) is tomorrow night. I should have something working before the weekend.
 In the meantime, some of my new friends have some good posts up. Check out The Lonely EMT and see what's on her mind, as well as EMS Chick and Just a Vollie as they all have some new stuff up.
Be Well, Be safe, Be Sharp,
UU

As Bad As It Gets

I've been in this business long enough to know that I will never have 'seen it all'. Kind of like when you say "Gee, it's awful quiet tonight!" and you get clobbered for the rest of the shift, saying that you've "seen it all" is a sure way to be certain that you will soon be greeted by a disturbing and bizarre job that could very well blow your mind. These are things a fool utters to make sure everyone is clear that he or she is a confirmed ass.
 However, I have been known to use the term "as bad as it gets" to describe a few jobs that were especially difficult. I have now put this one up with the others as a fools words.
 We worry about both ourselves and our team when we work the really ugly jobs and we watch them afterward so we can be there for them if they need us. What doesn't affect us, may bring somebody else down hard and vice versa. We all have our weak spots, and those of us who know our own weaknesses also know how to deal with it in one way or another. I've have talked down more than a few of my Brothers and Sisters, as they have done for me when I needed it, and yes, I have indeed needed it a time or two.
 I am by no means a trained counselor, and have at times directed co-workers toward professional help when I thought that was the right way to go. However, I believe I have learned a fair amount about what makes us tick, particularly from picking my own thoughts apart. It is knowledge gleaned through the pain of others as well as myself.
 After a recent horrific job, the one that made me hang up the words 'as bad as it gets', I spent considerable time with one of my Brothers working through things. He is doing very well now, but something he said made it all click in my head.
 There is a saying in the Fire Business that goes something like "if you are dispatched to a fire, expect fire". Now this may seem stupid at first, but the fact of the matter is that we get complacent about our ability to handle things and sometimes get caught off guard. "Expect Fire" means that while enroute, you get dressed and step off the truck ready to work, geared up, air pack on, with a tool in your hand. It's when we assume that it will be another defective alarm sensor that we get into trouble and behind the curve. Bad beginnings make for bad endings.
 So the epiphany I had was this: Every time I get  'messed up' by a bad job I find that I was taken by surprise by what I found, or the direction the job went in while I was safely assuming it would go the way I wanted. I looked at the folks I have helped through a 'rough patch' and realize now that they too were caught off guard. They didn't 'expect fire' and stepped off the truck to see a full working 3 banger. There is no time to play catch up in that situation, you will be behind for the entire event. I am speaking metaphorically, of course.
 Arriving at the chest pain call and only expecting 'chest pains' is a pretty silly way to approach such a call. If you walk in and find a newly dead person, you are already behind the curve, as this will throw you off your game in a big way.
 So I guess what I am saying is that if you always go in expecting the worst and are prepared for that, you will never be caught off guard. I am betting this is going to limit your psychological exposure.
 Please, give this some thought. Review the calls that gave you a hard time and ask yourself if you walked into it fully prepared, or if perhaps, you were just a little behind the curve. For myself, I never feel bad when I lose a patient while I was doing everything that I could do and the way it should be done. But I beat the hell out of myself if there is even the slightest possibility that I could have done something better, faster, or different.
 Be safe, be sharp, be ready,
UU
P.S. I will never be writing about the job that prompted this post. Some things are just not meant to be shared and some things are just so horrible that they defy belief or comprehension. The movie in my head will be a long time fading.

Why am I here? and What's My Plan? (4 of 4)

 So I've just re-read what I'd written in the 3 previous posts which only drew 1 comment and 1 direct email (thank you both). I had hoped for more, but I didn't expect too much so I'm not disappointed. I understand this is entertainment for most, not a participation sport. I expect some of the busier folks will stop by in the next week and I will still be interested to hear their comments.
 So after reading everything straight through and also having the benefit of having thought about this over the week, I have some new observations and I think, some adjustments to my direction.
 My first thought when I read everything straight through was "My gosh, I sound like a whiny spoiled child", "Woe is me". I had not taken stock of how lucky I am, nor have I even been aware of how good I have it.
 First, I work in a great Department with some really fantastic people that have taught me a lot about the Service and life in general. Some folks wind up in a hell hole where no learning takes place, gear is old and broken, and the best folks are barely competent. I got lucky, damned lucky, or I wouldn't have gotten the drive to be where I am now. Further, I have been allowed and encouraged to go outside the Department and learn from some of the very best and bring that stuff back, AND I have been permitted to do that teaching. So many of us get held back or held down by their Departments or co-workers because of politics or jealousy. I've been lucky.
 I've done some downright tough jobs as part of a good, supportive crew, and I have come back from the depths with them to rise to a higher level as a team. Few humans get to know what that feels like, but I do.
 Yes, I am old, but I'm not dead yet. My health is good, better than many my age, and I am in fairly good shape considering the roads I've been on in the last 55 years. (An old bull rider once told me "Son, it ain't the years, it's the miles what takes a man down.") I don't think you will find many 55 year old farts that will readily strap that air pack on and get in there. Not in the volunteer service, anyway.
 Instead of feeling like I am washed up, I should have been focusing on the blessings I've had, and continue to enjoy. I think I am focused now.
 I once had a Boss who was educated well beyond his intelligence and as he would say, 'here are my action items' to myself:
1) Be Happy you are alive and providing a valuable Service to the Department and Community. Most people never get to make that claim.
2) Keep working on being a good mentor to the youngsters and show them, by example what a good attitude and work ethic looks like.
3) Keep learning, because what you learn has value to others as well as yourself.
4) Stay healthy, keep working out, and make every Drill you can. Sweat is good.
5) Keep teaching every chance you can. It keeps you thinking and you learn from your students. Collect that stuff and spread it around. It will keep you young, too.
6) Don't worry about whether or not people respect you, they do. If they don't, you probably didn't want their respect anyway. If you do respectable work, treat others with respect, keep a clean and honest ethic, they will respect you, even if they don't like you.
7) Put the 'age thing' aside for now. Be aware that your body can not deliver what your mind demands anymore, but for now you are holding in. Don't let your pride get in the way of stepping back when that's what you should do. Don't put others in danger because of your short comings. But beyond that, let it all hang out man.
8) FDIC: It can STILL happen for you. You need to have faith and try to find a way to get there. The experience will be more than worth it. Just as with anything else you have already achieved, you need to make it a priority and keep working in that direction. (If FireCritic and the Iron Fireman can get all kinds of free stuff and have give-aways on their Blogs, you should be able to find a way to spend a week in Indy.)
9) Learn how to say "NO" firmly and with a smile. Schedule time for yourself first, then others later instead of the other way around.
10) Ease up on the 'blog thing'. The folks that read it will come read it when they want. getting regular posts out won't make much of a difference. Try to increase the quality while decreasing the quantity.

OK, that's what I came up with. I am guessing you are probably good with it too. If you have something to add or a correction to offer, please do. I don't know why one of you folks, who are supposed to be my friends, didn't tell me I sounded like such a whining jackass? Did you think you'd hurt my feelings? OK, I forgive you, but next time, you'd better let me know when I step off the truck on the wrong side.
 I appreciate you all listening to my head while I worked this thing out. My course correction has been loaded into the system and I'll be back on the road now. I hope you enjoyed the ride.
UU

Why am I here? (3 of 4) and What's Next?

 You should have read Part 1 and Part 2 (scroll down) of this before going further, you may decide you have better things to do with your time.
 I said at the beginning that I really didn't know where this was going to lead me and I still don't. It occurred to me that this whole series must seem like I am infatuated with myself and my problems. One of the big gun bloggers wrote just a few months ago that one should never write about themselves because 'nobody cares'. I suspect this is true, but on the other hand, the most predictable way to draw comments on the blog is by writing about something that may have caused oneself harm. I almost always get comments when somebody thinks I've been hurt, either physically or psychologically. It tells me that some folks do care. Anyway, I am not writing this because I think you want to know about me, I am writing this FOR ME, to work through the issues I face, and come up with a plan. There is a chance that some of you reading it will see something I don't and set me straight, or give me a clue to a new path. You folks are smarter than you might think, I've seen what you write.
 So let's move on, shall we?
 The final point about where I am now is that I feel like I am pushing too hard because I sense that I am running short on meaningful time. I teach regularly for the County from Fall to Spring each year (one class left this year) and I could teach more if I wanted. But between that, my responsibilities with my Fire Company (I am over at the station about 6 times a week making sure we stay combat ready), my responsibilities supporting the new Officers in the Rescue Company I recently left as Captain (they get about 2-8 hours a week from me), and my assignments from the Chief to support Department operations (another 2-8 hours a week) I am a pretty busy guy. Keep in mind that I hold down a 50hr/week on the paying job which also has responsibilities outside of the normal business hours from time to time. I get paid to get the job done, not just put in hours. So I guess you could see why I am tried a lot of the time when the pager goes off for the REAL REASON I do all this stuff. I didn't realize how tired I was until I left the Rescue Squad job and had more time on my hands (which I quickly filled). Finally, there is the time I spend on this blog either writing, or thinking about posts to write, or reading other blogs. I probably waste spend about 15 hours a week just reading whats out there.
 To summarize a little:  I am old. I am out of time to do what I had hoped to do. I believe I still have many contributions to make. I am wondering what the 'end game' is going to look like so that I can work toward that gracefully. I may be doing a little bit more than I can handle and I can't say "NO" very well, if ever.
 I have re-read what I've written up to this point and the easy answer I had hoped for it not presenting itself to me.
 I have contemplated leaving it up to you, the readers, to chime in with your thoughts, but I fully expect that it would only draw one or two comments, and that possibility would provide me with a very negative out look.  On the other hand, if you could spare a minute to leave a comment, that would probably be helpful and to be honest, I really am looking for some feedback here. I'm just not getting my hopes up, or hanging my hat on that.
 I am going to close this post out with an answer to the question I expect many of you are asking. You want to know what it is that I want. What do I need? Well, I suppose I already mentioned it either directly or not, but perhaps I wasn't specific. Perhaps I wasn't thinking about that myself. I usually think about what other folks expect from me first, and what I want second, then try to find a compromise in the middle. Usually this means I get a piece of what I wanted, and the others get what they asked for. Most times, I am good with that, I like making people happy. That makes me happy.
 But what I think I want is basically this: I want to to remain a valuable member of the team. I want to continue to provide front line service. I want to continue to teach the youngsters and help shape their ATTITUDES, if not their skills. I want to spend more time on the Fire Side, than EMS. I want to get out there and meet some of those big names whose books I have read. I would really like to see if I can get my teaching up to a higher level and provide a worthwhile experience to a larger audience. I want to end up being respected for the value I brought in, and lasted after I am gone. And yes, as a final detail, I want to find a way to get to FDIC before the clock runs out any further.
 So I think I will do this: I will close this post here and leave time for some comments that I hope will come. Whether they do or not, 48 hours after this post, I will put up my final post in the series with my plan going forward.
UU

Why am I here? (2 of 4) and Where Exactly Am I, Anyway?

 So part one covered the reason for this 'quest' of mine, to figure out where I am and where to go next. I have a lot of questions. But I suppose, if I am to properly to include you, the reader in this 'thing' I should give you a little more understanding of where I am. It might also help me get a better handle on it myself.
 First, if you are a regular reader, you've already picked up a bunch of background on me and painted a picture in your head of what and who I am. ( Six foot, three inches, 210 pounds of rippling muscle with an impressive mustache and an enticing smile.  OK, so maybe not. How about 5'5'', 190 pound teletubby, bald, and ugly? OK, neither of those are correct.) In case you have not been reading the blog for long, here is a post I put up about a year and a half ago with some of my background. Over the life of this blog I have let other details and facts about me slip into the written word. You will have to go dig those out for yourself. Those little things help you fill in your personal picture of who I am.
 Now I am going to tell you something you don't know, because I have guarded this fact since I decided to start the blog. In a few weeks I will celebrate my 56th birthday. Yeah, so when I have mentioned here that I am an 'old guy', you now know that I meant it. Not that 56 is ancient, but for what I do, it is considered old. In my Department I am the oldest guy that puts on an air pack and goes to work. I can tell my Chief doesn't like this much and her tries to avoid letting me in, but I still love the work and can do the job, even if I get winded sooner, and that 30 minute bottle only lasts about 20 minutes. I'll be honest and tell you that I know these days are gonna end soon. It could be any day, but for now I am safe, healthy, and competent. I still don't have too much trouble answering the off-hours calls, but it's getting rough on me when a call comes in at midnight and I stay up working it, or successive calls through the night and get no sleep at all. I have to be a presentable professional person when the clock strikes 8:00am and there are some days when that is very hard to do. Let me finish this point by adding that I do not have any illusions that I can keep up with the young guys and gals, however my part on the team is to provide some labor, but also some leadership to keep the younger folks focused and safe. My hope is that when my last day comes, they will have learned enough to do the same for those younger than themselves and continue on. So this 'age thing' is weighing very heavy on my mind of late. It is the main reason I have decided it is time to re-think where I am headed.
 The second cause for the 'quest' is my goals, or rather the realization that I will never be able to achieve the things I had hoped to do. I will never be the old grizzled Captain with 30 years of experience dispensing wisdom to the youngsters in their 30's. I came into the Service too late in my life to get that kind of time in. I will never be able to present a class at FDIC, at least I wouldn't lay any money on it, unless they start giving retirement fund classes, and I suck at that stuff anyway. Hell, one of my goals has always been to just ATTEND FDIC and I can't even get enough cash together to manage that. Although I have drawn  a line in the sand and told myself I am going to get there in 2012, I really don't know where I am going to find the cash and I don't have much of a workable plan. These last couple of weeks, I have been questioning if the trip would be wasted on me, being as old as I am. I also had a general goal of taking my time and training and putting it to the common good by either working as a State Fire Instructor, or a Fire Investigator in semi-retirement. This first one won't happen, but the second one is still open and mostly depends on the local politics.
 Six years ago, I started a training log to keep track of the hours I spent in the classroom for legitimate classes. I don't count department drills, or classes I teach, only classes I take that yield a certificate or a certification. Yesterday I was updating that log when I learned that I recently passed 1,000 classroom hours in registered classes. That's 63 classes in 6 years with an average of 165 hours per year. This is in spite of the fact that I consciously decided to back off in 2010 because I already had a lot of classes, and I still finished the year with 122 hours. This is about what I think every firefighter needs to stay current at a minimum. Knowledge is power, knowledge is safety. One of the reasons I take all these classes is so that I can pass this knowledge on to those who lack the time to take an entire class, but really need the basic information and training. I don't want to be one of those old grizzled Instructors who teaches things they way they learned them 'back in the day'. I want to be the guy the gives them the latest knowledge that can be had. There are still too many instructors teaching bad habits to new people. I vowed long ago I would not be one of 'them'.
 So you can see that not reaching my expectations for myself is a big part of where my head is at right now. This is the first time, ever, in my life that I can recall such a realization. This is probably because in the past, I could always take more time to reach my goal, and I would always meet or exceed it. But this time, there is no more time for me. The clock ran out and I'm still running up hill. I am, to say the least, disappointed with myself.
 The last major point that brings me to this 'quest' is wondering how this is all going to end. What will the 'end of the road' look like for good ol' UU? Do I live out a long (perhaps too long) life and die in a nursing home bed someplace where my kids won't come visit me because I don't remember them and give them grief when they do come? Do I become an LODD for something stupid during a split second lapse in judgment or because (worse yet) I didn't back off when I should have? I know for sure I will never retire to a life of fishing, reading, and enjoying life. For one thing, the finances aren't there and I'll probably have to work until I die. For another, I have to be fully involved in something that makes me feel worthwhile. The Fire Service does that for me, and that's why I put so much effort into it, it makes me whole. I am quick to admit to myself that I volunteer my time, effort, and soul to the community because it compensates, in my mind, for something I lack as a member of society. I am not too clear what it is that is lacking, but I am sure that I owe more than I am owed. No, I do not know why I feel this way, I just do. It's what makes me get out of a warm bed at 2am, I fell like I owe it to somebody.
 In part 3 we'll finish up with where I am now, and we'll move on to what the options are.
UU